OBJECTIVES Check-in kiosks are increasingly used in health care. This project aims to assess the effects of kiosk use upon check-in duration, point of service (POS) financial returns, and patient satisfaction. METHODS Six kiosks were implemented in a large academic orthopedic clinic, and check-in duration for 8.5 months following implementation and POS returns for 10.5 months before and after implementation were analyzed. Consumer Assessment of Healthcare Providers and Systems Clinician and Group survey and self-devised surveys recorded patient satisfaction. RESULTS Cumulatively, 28,636 kiosk-based patient encounters were analyzed. Compared with historical norms, check-in duration decreased 2 minutes, 47 seconds (P less then 0.001). Daily gross and individual POS returns increased $532.13 and $1.89, respectively (P less then 0.001). Satisfaction surveys were completed by 719 of 1376 consecutive patients (52% response rate), revealing 12% improvement (P less then 0.001), but Consumer Assessment of Healthcare Providers and Systems Clinician and Group survey responses demonstrated no change (P = 0.146, 0.928, and 0.336). CONCLUSIONS Kiosks offer to reduce check-in duration and increase POS revenue without negatively affecting patient satisfaction.OBJECTIVES The aim of the study was to determine whether a system process change improved successful read-back of critical values by the appropriate provider. METHODS The study implemented a system process change of switching the "first call" physician from the admitting physician to the most recent document writer. Data were compared before (N = 301) and after the intervention (N = 201). Predictor variables included patient factors, physician factors, and environmental factors. The outcome variables measured were successful read-back within 5 and 30 minutes. RESULTS Read-back failure within 5 minutes was significantly reduced (P less then 0.001) from preintervention (49.5%) to postintervention (31.3%). Multivariate logistic regression showed reduced odds for read-back failure postintervention (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.31-0.67, P less then 0.001) and increased odds for read-back failure for patients of Hispanic race/ethnicity (OR 1.77, 95% CI 1.09-2.89, P less then 0.05). Read-back failure within 30 minutes did not significantly change. Multivariate logistic regression showed that an increased number of telephone calls were associated with an increased odds for read-back failure (OR 3.12, 95% CI 2.13-4.57, P less then 0.001). CONCLUSIONS We recommend the use of the physician who has most recently engaged with the patient as documented in the medical record for the daily note as the primary source of contact for reporting critical values.OBJECTIVES There is limited evidence for the use of salt tablets in the treatment of hyponatremia. This retrospective study evaluated the effectiveness of salt tablet administration in euvolemic hyponatremia. METHODS This was a single-center, retrospective cohort study. https://www.selleckchem.com/products/syrosingopine-su-3118.html Information on patients' demographics, clinical characteristics, and laboratory data were collected for retrospective review. Treatment for hyponatremia, including the amount of salt tablets, fluid restriction, and diuretics was collected. We compared hyponatremic patients with those who received salt tablets versus those who did not receive salt tablets. The primary outcome of interest was the change in serum sodium at 48 hours between the two groups. RESULTS A total of 1258 medical records were initially screened with inclusion and exclusion criteria. After screening, there were 83 patients included in the study. Forty-two patients received salt tablets and 41 patients were in the group that did not receive salt tablets. Patients treated with salt tablets were older, more often female, and had lower body weight and lower initial serum sodium. The change in serum sodium after 48 hours was higher in the salt tablet group (5.2 mEq/L) than the non-salt tablet group (3.1 mEq/L; P less then 0.001). This difference in serum sodium between the two groups remained statistically significant when adjusted for age, sex, weight, and initial serum sodium. CONCLUSIONS The use of salt tablets in the treatment of euvolemic hyponatremia is associated with a small but significant improvement in serum sodium compared with patients who did not receive such therapy, even after adjusting for age, sex, weight, and initial serum sodium. This study supports the effectiveness of salt tablets in the treatment of euvolemic hyponatremia in medical patients.OBJECTIVES Acid suppression therapy (AST), composed of proton pump inhibitors (PPIs), histamine-2 receptor blockers, and antacids, is one of the most common medication groups used in the United States. Long-term AST is concerning, however, because it is linked with an increased risk of community-acquired pneumonia, Clostridium difficile infections, bone fractures, and nutritional deficiencies. The potentially harmful biological and economic consequences associated with the improper use of acid suppression medications presents a great deal of risk to those in underserved communities. We sought to determine the prevalence of AST in an underserved population and the common diagnoses and symptoms associated with therapy. In addition, we studied the frequency of suboptimal usage of PPIs in an indigent care population and the potential factors related to high-risk behaviors. METHODS The study was a cross-sectional study using a survey that was distributed to participants during their regularly scheduled visits to a public sector provider of health care for low-income patients. RESULTS Of the 176 participants surveyed, 70 (40%) were using AST. Esophagitis and gastroesophageal reflux disease were the most prevalent in our sample population. PPIs were the most common acid suppression medication used in our population. Of those using PPIs, 85% were never instructed to cease use. Of the 27 patients with PPI prescriptions, 26 used it in a suboptimal manner, and of those without prescriptions, 7 used it in a suboptimal manner. CONCLUSIONS ASTs are prevalent in low-income populations, and patients are not being managed appropriately to minimize their risk for complications of AST.